| NPI | 1952481210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301071280) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA 4301071280) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-09 |